Abstract

Editorial Office. Items pertaining to manuscripts submitted for publication, letters, and all other communication relating to the editorial management of the Journal should be sent to: Donald Y. M. Leung, MD, PhD, Editor in Chief The Journal of Allergy and Clinical Immunology National Jewish Medical and Research Center 1400 Jackson St., Suite J324 Denver, CO 80206Telephone: (303) 398-1963Fax: (303) 270-2269 In January 2002, the Journal adopted a Web-based editorial office system with full electronic submission, review, and status update capabilities. All manuscripts must now be submitted online at the Journal's Editorial Manager Web site; the address is http://www.editorialmanager.com/jaci. Electronic files of the manuscript contents must be uploaded at the Web site, and a PDF will be automatically built by the system. Required copies of the submission form, copyright documents, and conflict of interest statements or permissions (when applicable) should be transmitted by fax to (303) 270-2269. The Required Submission Form and Transfer of Copyright statement can be downloaded from the Editorial Manager home page. Glossy prints of illustrations should be clearly and completely labeled (see section A10, Figures) and sent directly to the Editorial Office by express mail or rapid courier at the time of revision or acceptance. Complete instructions for online submission are located in the ATTENTION AUTHORS section of the JACI's Editorial Manager Web site at http://www.editorialmanager.com/jaci. A Tutorial for Authors, Guidelines for Submitting a Revised Manuscript, Transfer of Copyright, a Submission Checklist, and General System Requirements are all available at the Editorial Manager Web site. Complete guidelines for preparation of your manuscript are located below. Technical support is available by e-mail at [email protected] . In any correspondence, please provide the corresponding author's name, title of the manuscript, manuscript number (if assigned), and a clear description of the problem. Manuscripts that do not conform to the guidelines below will be delayed in processing. Copyright. Most of the provisions of the Copyright Act of 1976 became effective on January 1, 1978. Therefore, EVERY MANUSCRIPT MUST BE ACCOMPANIED, WITHIN 24 HOURS AFTER COMPLETION OF ONLINE SUBMISSION, BY THE FOLLOWING WRITTEN STATEMENT, SIGNED BY ALL AUTHORS: “The undersigned author(s) transfer all copyright ownership of the manuscript [insert title of article] to the American Academy of Allergy, Asthma and Immunology, in the event the work is published. The undersigned warrant(s) that the article is original, does not infringe upon any copyright or other proprietary right of any third party, is not under consideration by another journal, and has not been previously published. The author(s) confirm that they have reviewed and approved the final version of the manuscript.” Items are accepted for publication on the understanding that they are contributed solely to The Journal of Allergy and Clinical Immunology (JACI) and have not been or will not be published elsewhere except in abstract form. Authors will be consulted, when possible, regarding republication of their material. Within 24 hours after completion of the submission process, you must send the completed Transfer of Copyright statement and Submission Checklist to the JACI Editorial Office by fax at 303-270-2269. Requesting permission to reuse previously published material. Authors of manuscripts submitted to The JACI must provide the Editorial Office with proof of permission to reuse previously published material for any figure or table that has appeared in another publication. To request permission, please contact the appropriate journal or publisher and provide the following information:•Your name, institutional affiliation, mailing address, telephone and fax numbers, and e-mail address•Source of previously published material: full title of journal or book, article title, author names, volume, year, and page numbers•Amount of the material to be used—please specify particular pages, tables, or figures (specify table/figure numbers)•Intended use of the published material—please state that you are seeking publication in The Journal of Allergy and Clinical Immunology, and provide the article title, name of the first author, JACI year and volume number (or indicate In press), and the number of the table or figure in the JACI submission in which the material will appear. Upon obtaining written permission to reuse the specified material, forward the documentation to the JACI Editorial Office. Acceptance of a manuscript is conditional upon receipt of permission. Liability. “Statements and opinions expressed in the articles and communications herein are those of the author(s) and not necessarily those of the Editor(s) or publisher, and the Editor(s) and publisher disclaim any responsibility or liability for such material. Neither the Editor(s) nor the publisher guarantee, warrant, or endorse any product or service advertised in this publication, nor do they guarantee any claim made by the manufacturer of such product or service.” Conflict of interest. The Journal requires all authors to acknowledge, on the title page of the manuscript, all funding sources that supported their work as well as all institutional or corporate affiliations of the authors. Authors are also required to disclose to the Editor, in a cover letter provided at the time of submission of a manuscript, any commercial associations that might pose a conflict of interest. These include consultant arrangements, stock or other equity ownership, patent licensing arrangements, or payments for conducting or publicizing the study. The disclosure will be held in strict confidence during the review process and will not influence any editorial decisions. However, if the paper is accepted for publication, the Editor will determine how any conflict of interest should be disclosed. Manuscript length. Authors must comply with the page limits that have been established for each type of article. Manuscripts that exceed standard limits for length will be returned to the authors to be shortened before peer review can be initiated. Articles of excessive length will not be accepted for publication. As of October 2003, the Journal will consider posting ancillary materials (nonessential tables, figures, appendices, questionnaires, and so forth) in an Online Repository on the JACI Web site. The Online Repository is for peer-reviewed material that cannot be included in the print version of an article because of space considerations. For instructions, see Guidelines for submission of Online Repository materials (below). The Journal will consider publication of several types of manuscripts: These should describe fully, but as concisely as is feasible, the results of original clinical and/or laboratory research. For complete instructions regarding the online submission process, please refer to the Tutorial for Authors on the Journal's Editorial Manager home page at http://www.editorialmanager.com/jaci. Be sure the entire manuscript (all text, legends, captions, and so forth) is in a standard font such as Times New Roman, Arial, or Courier; the font size should be 12 points. All sections, including references, should be double-spaced, with a page margin of at least 1” on every side. On each page, the last name of the first author and the page number should appear in the upper right corner. Begin numbering with the title page as page 1. Please add line numbers to the left margin of both the abstract and the manuscript text (Introduction through Discussion). Line numbering (count by ones) can be added through the Format menu of most word processing programs. Original articles may not exceed seven printed pages, including text, references, tables, and figures. To estimate the number of printed pages that a manuscript will require, calculate one printed page for every 3 pages or 750 words of double-spaced, 12-point Courier typescript; one half page for every 25 references; and one fourth page for each 3″ × 4.5″ table or figure (or part of a multipart figure) plus legend. A printed page measures 6” wide by 9″ high. Graphic presentations must be sized to one (3″) or two (6″) column widths (see section A10). Authors must comply with the page limits established. The manuscript should be organized in the order set forth below. Failure to follow this format may result in the manuscript being returned to the author(s) for revision before review. The title page, abstract, keywords, abbreviations, text, acknowledgments, references, tables, and figure legends should be included in one word processing file (in .doc or .wpd format). Figures should be loaded as separate files in the format specified below.1.Title page. The full title should be relevant and concise (less than 15 words). It should be followed by the list of authors, including their full names, highest academic degrees, and institutional affiliations. Restrict the number of authors to those who have made material contributions to the research and who contributed to the writing and review of the manuscript. In the bottom half of the title page, list the corresponding author's name, address, telephone number, fax number, and e-mail address, as well as an address for reprint requests.Funding sources. All sources of funding should be declared on the title page. Authors are required to disclose any financial relationship with a biotechnology and/or pharmaceutical manufacturer that has an interest in the subject matter or materials discussed in the submitted manuscript.A total word count must be provided on the manuscript's title page. The total word count pertains to the body of the manuscript (Introduction through Discussion only); the abstract should not be included in the count. Figure and table legends are included in the estimation of the overall space required for figures and tables.2.Abstract. The abstract must be no longer than 250 words. It should summarize the results and conclusions concisely. Tabular data should not be included, and acronyms/abbreviations should either be avoided or be spelled out fully. Abstracts should be structured as follows:Tabled 1Background:What is the major problem that prompted the study?Objective:What is the purpose of the study?Methods:How was the study done?Results:What are the most important findings?Conclusion:What is the most important conclusion drawn and what is the clinical relevance of the results? Open table in a new tab 3.Keywords. A list of up to ten keywords should follow the abstract.4.Abbreviations. Provide a list of any abbrevia-tions/acronyms (and their definitions) on a separate page following the keywords. Only standard abbreviations are to be used. Consult Scientific Style and Format by the Council of Biology Editors or the 9th edition of the AMA's Manual of Style. (Abbreviations are not acceptable in the title. They should be avoided in the abstract, if possible.) A laboratory or chemical term or the name of a disease process that will be abbreviated must be spelled out at first mention, the acronym or abbreviation following in parentheses.5.Text. The manuscript should be written clearly and concisely in English. Authors whose primary language is not English should obtain assistance with writing to avoid grammatical problems. The text should be organized in sections as follows: Introduction, Methods, Results, and Discussion. Each section should begin on a new page. The generic terms for all drugs and chemicals should be used.Study subject coordination. In studies involving human subjects, a statement describing approval by the Institutional Review Board is required. Studies involving experimental animals must include a statement in the Methods section indicating which guidelines for the care and use of the animals were followed (eg, the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research or the “Guide for the Care and Use of Laboratory Animals” prepared by the Institute of Laboratory Animal Resources, National Research Council, and published by the National Academy Press [revised 1996]).6.Acknowledgments. General acknowledgments for consultations, statistical analyses, and the like should be listed at the end of the text, including full names of individuals involved. Acknowledgment of funding should be listed on the title page.7.References. References should follow Cumulated Index Medicus style. Manuscripts in preparation, personal communications, and other unpublished information should not be cited in the reference list but may be mentioned in the text in parentheses. The references must be identified in the text by superscript Arabic numerals and numbered in consecutive order as they are mentioned in the text. The list of references, in numeric sequence, should be typed double-spaced at the end of the article. Please do not use your word processing program's footnote or endnote feature (or any programs such as EndNote or Reference Manager) to create citations. The publisher cannot work with manuscripts containing this formatting, and they will be returned to the author. The format should conform to that set forth in “Uniform Requirements for Manuscripts Submitted to Biomedical Journals” (Ann Intern Med 1997;126:36-47). Please note that inclusive page numbers are required. List all authors' names when there are six or fewer; when there are seven or more, list the first six and add et al.EXAMPLES OF REFERENCES:Journal article:Parkin DM, Clayton D, Black RJ, Masuyer E, Friedl HP, Ivanov E, et al. Childhood leukaemia in Europe after Chernobyl: 5-year follow-up. Br J Cancer 1996;73:1006-12.Book:Ringsven MD, Bond D. Gerontology and leadership skills for nurses. 2nd ed. Albany (NY): Delmar Pub-lishers; 1996.Chapter in a book:Phillips SJ, Whisnant JP. Hypertension and stroke. In: Laragh JH, Brenner BM, editors. Hypertension: pathophysiology, diagnosis, and management. 2nd ed. New York: Raven Press; 1995. p. 465–78.Internet resource:US positions on selected issues at the third negotiating session of the Framework Convention on Tobacco Control. Washington, DC: Committee on Government Reform, 2002. (Accessed 4 March 2002 at http://www.house.gov/reform/min/inves_tobacco/index_accord.htm.)8.Tables. If tables appear in the manuscript, they must be included in the electronic submission. They may be placed in the manuscript file or loaded separately. Tables should supplement, not duplicate, the text; they should be on separate pages, one table per page, and should be self-explanatory and numbered with Roman numerals in order of mention. Provide a brief title for each table. At the bottom of the table, define any abbreviations that appear in the table. Glossy prints and reduced versions of typewritten tables are unacceptable. The table number should appear in the electronic file. The maximum size for a table is page. The maximum number of illustrations (tables and figures) per manuscript is 8.9.Figure legends. Figure legends should be typewritten, double-spaced, and listed on a separate sheet of paper preceding the tables. They should not appear on the figures. The legends should be succinct (no more than 60 words), serving the purpose of simple identification of the data or subject being presented and not as an explanation.10.Figures. If illustrations appear in the manuscript they must be submitted in electronic format as part of the manuscript. They should be submitted in separate files. Complete instructions for online submission are available at the Journal's Editorial Manager Web site (http://www.editorialmanager.com/jaci), on the home page under ATTENTION AUTHORS.Graphics software such as Photoshop or Illustrator is required for the creation of figures (the publisher will not accept images created in presentation software such as PowerPoint, CorelDraw, or Harvard Graphics). All images must be provided in TIFF or Illustrator EPS electronic format. Illustrator EPS is preferred for line art and text. Color images need to be in CMYK mode, with a minimum resolution of 600 dpi (dots per inch). Black-and-white images need to be in grayscale mode, with a minimum resolution of 300 dpi (dots per inch) for any photographic image with no text or 1000 dpi for any image that includes text. Line art (black and white or color) should be at least 1000 dpi. The Journal now requires glossy prints for all figures, to be submitted at the time of revision or acceptance of a manuscript.The figure number should appear within the electronic image, beneath the figure but not in it, so that the figure can be quickly identified both online and in hard copy. Original prints should not be mounted on paper. Glossy prints of figures submitted with a revision must be numbered lightly on the back with the manuscript and figure number, the first author's last name, and an arrow marking the top edge. “Glossy print” means the use of photo-quality paper with a glossy finish. Laser prints or photocopies are not acceptable.The maximum number of figures per manuscript is 6. The maximum number of graphic illustrations (figures and tables combined) is 8. Authors should consider submitting at least one color key figure or conceptual illustration that captures the essential message of the manuscript. This will enhance the article and provide clarity for the readers. Color illustrations will be reviewed and approved by the Editor.Important: In colorizing your figure(s), we ask that you keep in mind that some of our readers are color-blind and are often unable to distinguish different colors in graphically represented data. To accommodate this group, we suggest that you consider some type of aid, such as labeling each column of a bar graph with an identifier or providing a key with symbols identifying each set of data being presented or compared. It is also helpful to use colors of varying intensities so that they are distinguishable as different shades of gray when viewed by the color-blind. We thank you for complying with this request.Black-and-white graphs must be legible, jet-black on white background. Each graph should be designed to be printed in a single 3” column. Value labels and legends should be in an easily legible font, such as Times New Roman or Helvetica Regular. Bold or italic typefaces are not acceptable except for special emphasis on particular words or phrases. For each label, the first letter should be in upper case and the remainder in lower case; do not use all capitals. Labels directly on the graph rather than in the legend are encouraged. The font size must be ≥14 points and the line width 1 point or more for 6” graphics and proportionally smaller for 3” graphics. Keep a consistent font and size throughout each figure and for all of your figures to provide higher readability. The fill for bar graphs or pie charts should be distinctive; avoid shading. If more than 2 bars are used in a graph, please use cross-hatching for adequate contrast. Fills with unnecessary patterns will be returned for revision. Three-dimensional graphics may be used only when there are 3 coordinates (x, y, and z). Do not include color images and black-and-white images in the same electronic file.Every figure must be created at a size suitable for publication. The maximum size allowed for any illustration is 6″ wide by 4.5″ high (for a 2-column width) and 3″ wide by 8″ high (for a 1-column width). The figure legend will be included in the size of the figure, and this must be taken into consideration when estimating size. Keep the figure legend succinct—no more than 60 words (” of text for a 2-column-width figure or 1” of text for a 1-column-width figure). Do not place titles or legends within figures; titles and legends should be included on the Figure Legends page (see section A9). The title should appear at the outset of the legend for each graphic presentation. Specific instructions for figure sizing are available in the tutorials on the Journal's Editorial Manager home page under ATTENTION AUTHORS.It is the responsibility of the author to ensure that all elements within a figure are of high clarity and are easily legible and that the figures are as uncluttered and compatible in size and format with companion illustrations as possible. If these criteria cannot be met, a figure should be divided into multiple figures to allow proper sizing and greater detail. Inclusion of figures in the Journal's Online Repository also offers a solution for presentation of overly large illustrations.Figures must be cited in the text and numbered in order of mention.11.Permissions. Direct quotations, tables, or illustrations that have appeared in copyrighted material must be accompanied by written permission for their use from the copyright owner and original author, along with complete information as to the source. Photographs of identifiable persons must be accompanied by signed releases showing informed consent. Because articles appear in both the print and the online versions of the Journal, wording in the permission should specify “permission to publish in all forms and media.” Failure to obtain electronic permission rights might result in the images not appearing in the online version. For further direction, please see “Requesting permission to reuse previously published material,” above.12.Nucleotide sequence data. When a manuscript includes or describes original sequence data, the authors must submit these data to GenBank. A footnote must include the accession number under which the data were submitted. Instructions are available from GenBank, Mail Stop K710, Los Alamos National Laboratory, Los Alamos, NM 87545 (telephone [505] 665-2177).13.Protein sequence data. When a manuscript includes or describes original protein sequence data, the authors must submit these data to Protein Identification Resource (PIR). A footnote must include the accession number under which the data were submitted. Instructions are available from PIR, National Biomedical Research Foundation, Georgetown University Medical Center, 3900 Reservoir Rd. N.W., Washington, DC 20007 (telephone [202] 687-1672).14.New allergen data. When a manuscript includes or describes a hitherto unnamed allergen, the authors must contact the WHO/IUIS Allergen Nomenclature Sub-Committee for approval of a new name. A footnote should indicate that the data have been submitted. A questionnaire is available from Allergen Nomenclature Sub-Committee, Bøge Allé 10-12, DK-2970 Hørsholm, Denmark (telephone 45-45-76-7777 #5116; fax 45-45-76-5152; Internet, anonymous FTP to biobase.dk:pub/who-iuis/newallergen.nomenclature and pub/who-iuis/newallergen.form).15.Microarray gene expression papers. As of January 2004, all papers reporting studies of gene microarray expression must use the MIAME guidelines (available at http://www.mged.org/Workgroups/MIAME/miame_checklist.html) for organization of the report and presentation of data. Descriptions of experimental conditions and data collection should be prepared for the JACI's Online Repository. The Editors will consider succinct manuscripts (not more than 2000 words and 2 tables or figures) summarizing novel experimental results of exceptional importance or urgency. Authors should identify and justify such manuscripts in a cover letter to the Editors. The format and characteristics for these papers will be identical to those outlined for standard submission manuscripts (see section A). Such papers, if accepted, will appear at least one issue sooner than standard manuscripts. The Editors may choose (after notification to authors) to consider such manuscripts as regular publications. Letters to the Editor are brief reports of clinical or laboratory observations, substantiated by controlled data but limited in scope and without sufficient depth of investigation to qualify as original articles. These manuscripts are reviewed in the Editorial Office and undergo peer review. Citation research shows that Letters to the Editor are indexed in Medline, accessible to literature searches, and cited as original articles. A Letter to the Editor must:1.Be limited to two printed pages, including references and illustrations. To calculate length, count 1 page for each 750 words; one fifth of a page for 10 references, and one fourth of a page for a standard 3″ × 4.5″ table or figure.2.Have a short, relevant title3.Include a title page and unstructured abstract—see section A1 (Although the abstract will not be published with the Letter, it is necessary for preview by peers invited by the Editorial Office to review the manuscript.)4.Begin with the salutation “To the Editor”5.Close with the author name(s), academic degree(s), institutions(s), and location(s)6.Have no more than ten references7.List the references as complete bibliographic citations following the closure of the letter (see section A7 for formatting)8.Present lists of Keywords and Abbreviations, as relevant—see sections A3 and A49.Have no more than two single-part tables or figures—see sections A8 and A1010.Be accompanied by a signed Transfer of Copyright statement signed by all authors. Correspondence concerning recent publications in the Journal or other subjects of unique interest to the readership will be considered for publication and accepted on the basis of their pertinence, their scientific quality, and the availability of space in the Journal. When a particular Journal article is referenced in a Correspondence considered acceptable for publication, a response from the authors of the article will be requested. The Correspondence and the relevant Reply will be published together. A Correspondence manuscript or Reply manuscript must:1.Contain no more than 500 words (this count will include any brief tabular data)2.Have a complete title page—see section A13.Have a short, relevant title (distinct from the title of the referenced article)4.List the references as complete bibliographic citations at the end of the letter, with the Journal article being discussed given as the first reference (see section A7 for formatting)5.Cite references (where appropriate to the subject)—but no more than three6.Have no more than one table or figure (see sections A8 and A10)7.Begin with the salutation “To the Editor” and close with the author name(s), academic degree(s), institutions(s), and location(s)8.Be accompanied by a signed Transfer of Copyright statement signed by all authors. Review articles published in the Journal have been specially requested in collaboration with the programs of the Postgraduate Education and Continuing Medical Education Committees of the American Academy of Allergy, Asthma and Immunology. Current space constraints do not allow for acceptance of unsolicited review manuscripts. Opinion articles on subjects of particular interest and/or debate are accepted for peer review after preliminary review by the Editor. Each of these Rostrum articles is limited to six printed pages and should follow the guidelines for original articles (see section A), including the presence of an unstructured abstract of no more than 250 words. Case studies, which are published by special invitation only, present interesting and difficult clinical cases to illustrate the power of science in helping a clinician come to an accurate clinical diagnosis and treatment plan for a patient. Emphasis should be placed on pathogenetic mechanisms, the use of the clinical immunology laboratory to solve diagnostic problems, and the role of the allergist or clinical immunologist as an expert in dealing with difficult cases. A Case Study must:1.Follow the guidelines for original manuscripts regarding length, bibliographic style, copyright and other required documentation, and other matters as applicable—see section A2.Contain a brief, unstructured abstract (no more than 250 words)3.Be structured as follows:3.1.Case presentation3.2.Differential diagnosis3.3.Laboratory and other testing and/or procedures3.4.Tentative diagnosis with discussion of pathogenesis3.5.Final diagnosis with treatment and/or management plans3.6.Summary statement with table of “clinical pearls” to help the clinician make the diagnosis and manage the patient. Submission of revisions must be made electronically to the Journal's Web-based editorial office (Editorial Manager) at http://www.editorialmanager.com/jaci. Ensure that the revised manuscript is prepared in accordance with the Journal's format and style for the type of article you are revising. Please refer to Guidelines for Submitting a Revision, which is available in the ATTENTION AUTHORS section of the Journal's Editorial Manager home page. Adherence to these guidelines is important to prevent a delay in processing the manuscript. Include the following:1.Electronic files of the complete revised manuscript; include a MARKED version and an UNMARKED version. The MARKED version should use strikeouts to indicate deletions and underlining to indicate additions to the original version. The UNMARKED version represents your revised manuscript as you intend it for publication. Include the tables and figures with both versions.2.A point-by-point response to the comments made by Reviewers, Editors, and the Editorial Office. In your response, reproduce each of the comments, in its entirety and exactly as it was made; a reply from you should follow each comment. Indicate the difference between the comment and your reply by changes in font and style and by use of the words “Comment” and “Reply.” If changes and/or additions have been made to the previous version of the manuscript, indication must be given of where these changes have been made in the manuscript or explanation of why the authors feel that the changes are not appropriate.3.Electronic files for each figure and table (see section A) for both the MARKED and the UNMARKED versions of your manuscript. Glossy prints of all figures must be sent to the Editorial Office by courier or express mail at this time. Prepare the electronic files before you go online. Please note the formats for files that Editorial Manager can upload and the publisher can use.•For text and table files: use Word or WordPerfect.•For graphics files: use TIFF or Illustrator EPS.•Do not submit files in HTML or PDF format. They cannot be used by the Publisher. Please be sure that all text, legends, captions, and so forth are in a standard font, such as Times New Roman, Arial, or Courier. Use of Asian fonts can cause a file to fail to display in the PDF if the recipient computer does not have the correct language support program. All design considerations regarding typefaces, page layout, and artwork will be handled by the publisher after an accepted paper has been transferred from the Editorial Office to the publisher. Please do not input any special typesetting codes. Be careful to distinguish between the letter O and the numeral 0 and between the letter I and the numeral 1. A “hard return” results from pressing the Enter key on the computer keyboard. Use hard returns only at the ends of paragraphs, titles, and headings, to separate items in a bulleted or numbered list, and so forth. Rely on the word processing program's word wrap (“soft return”) feature for all other endings.•Use the program's Page Break function to begin a on a new page.•Use the word processing program's capabilities for bold, underlining, italic, subscript, and superscript. Text that is to be italicized in published form (eg, genus + species designations) may be keyboarded through use of either italic or underlined text.•Do not right-justify or center any text or headings.•Use two hyphens for a long dash.•When creating a table, use the word processing pro-gram's table formatting feature; otherwise, use only tabs (not spaces) to align columns.•In order to enable the publisher to use electronic files, it is crucial that the word processing program's footnote or endnote feature, or bibliographic programs such as EndNote or Reference Manager, not be used to create reference citations. Type references in a numbered list at the end of the text, and use superscript Arabic numerals within the text to cite references. As of October 2003, the Journal will consider posting ancillary materials (nonessential tables, figures, appendices, questionnaires, and so forth) in an Online Repository at the JACI Web site (http://www.mosby.com/jaci). The Online Repository is for peer-reviewed material that cannot be included in the print version of an article because of space considerations. Readers of the Journal's print version will be directed to the Online Repository for reference. On an individual basis, the Editors will determine whether ancillary material submitted in support of a manuscript is warranted. In some instances, an Editor may suggest when requesting a revision that part of the data be presented in the Online Repository and removed from the manuscript, perhaps at the request of the Reviewers. In both cases, authors should include a cover letter to the Editor, indicating the material to be considered for the Online Repository and justifying its inclusion. Guidance will be provided for its preparation. The ancillary material must be submitted in Editorial Manager simultaneously with the rest of the manuscript. The ancillary files should be loaded last in the Attach Files step using the appropriate Submission Items. For revisions that will include newly designated Online Repository material, the MARKED manuscript should show where materials were removed from the original version and should include appropriate statements directing the reader to the Online Repository. The UNMARKED manuscript will reflect the latter changes. See the Tutorial for Authors for new submissions or the Guidelines for Submitting a Revision for revised submissions (available on the Journal's Editorial Manager home page) for instructions regarding all of the above. All text Online Repository files should be formatted per directions for regular manuscript materials (see section A). Figures for the Online Repository do not need to conform to the print specifications for resolution, but they do need to be clear and crisp. PowerPoint files may be used. Online Repository materials must be accompanied by a separate title page that includes the heading “Online Repository,” all author names and their affiliations, and contact information for the corresponding author. Figures and tables must be labeled with unique designations: Figure E1, Table E1, and so forth. Similarly, if citations are made within the ancillary material, a list of references—separate from the manuscript's references—must be included; these references should be labeled E1, E2, and so forth. Sentences or references that are included in the manuscript may be repeated in the Online Repository material if this is necessary for the sake of comprehension. In the manuscript text, materials that are housed in the Online Repository must be referenced specifically (eg, “see Fig E1 in the Online Repository”), but the materials should not be included as part of the manuscript itself. It is important to remember that materials for the Online Repository are independent from the manuscript and will appear online only. Color overprints are offered to authors before publication of the Journal at the same price as black and white reprints. An overprint consists of stapled pages that are printed at the same time that the Journal is printed, and the first and/or last page might contain part of the preceding article or the following article. Custom color reprints purchased after publication are extremely expensive, and therefore authors are encouraged to verify the costs of reprints versus overprints before publication of their article. Updated September 29, 2003

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